<%@ page language="java" import="java.util.*" pageEncoding="UTF-8"%>
<%@ taglib prefix="c" uri="http://java.sun.com/jsp/jstl/core" %>
<!DOCTYPE HTML PUBLIC "-//W3C//DTD HTML 4.01 Transitional//EN">
<html>
  <head>
	  <title></title>
  </head>
  
  <body>
  <h2 align="center">添加核酸检查信息</h2>
    <form id="formid" align="center" method="post" action="${pageContext.request.contextPath}/detail/insert">
		<strong>被检查人姓名(*)</strong><input type="text" id="assay_user" name="assay_user"><br/><br/>
		<strong>被检查人手机号(*)</strong><input type="text" id="phone" name="phone"><br/><br/>
		<strong>被检查人身份证号(*)</strong><input type="text" id="card_num" name="card_num"><br/><br/>
		<strong>检测机构(*)</strong>
		<select id="hospitalId" name="hospital_id" >
			<option value="0">请选择</option>
			<option value="1">河南省人民</option>
			<option value="2">u科医院</option>
			<option value="3">郑州人民医院</option>
		</select><br/><br/>
		<strong>检测日期(*)</strong><input type="text" id="assay_time" name="assay_time"><br/><br/>

    	<input type="submit" name="insert" value="提交"><input type="button" value="返回" onclick="history.go(-1)">
    </form>
  </body>
</html>
